Dietary and Demographical Risk Factors for Oesophageal Squamous Cell Carcinoma in the Eastern Anatolian Region of Turkey Where Upper Gastrointestinal Cancers are Endemic

Background: Oesophageal squamous cell carcinoma (ESCC) is endemic in the Eastern Anatolian region ofTurkey. The present study was performed to identify risk factors for ESCC that specifically reflect the demographyand nutritional habits of individuals living in this region. Materials and
Methods: The following parameters werecompared in 208 ESCC patients and 200 control individuals in the Eastern Anatolian region: age, sex, place ofliving, socioeconomic level, education level, smoking, alcohol intake, nutritional habits, and food preservationmethods.
Results: The mean age of ESCC patients was 56.2 years, and 87 (41.8%) were 65 years-old or older.The ratio of women to men in the patient group was 1.39/1. ESCC patients consumed significantly less fruit andyellow or green vegetables and more hot black tea, ‘boiled yellow butter’, and mouldy cheese than did controlindividuals. Residence in rural areas, smoking, and cooking food by burning animal manure were also significantlyassociated with ESCC.
Conclusions: The consumption of boiled yellow butter and mouldy cheese, which arespecific to the Eastern Anatolian region, and the use of animal manure for food preparation were identified asrisk factors in this region. Further studies are required to potentially identify the carcinogenic substances thatpromote the development of ESCC in this region.